title: A pilot randomized trial evaluating low-level laser therapy as an alternative treatment to manual lymphatic drainage for breast cancer-related lymphedema.
abstract: OBJECTIVE
  To examine the impact of advanced practice nurse (APN)-administered low-level laser therapy (LLLT) as both a stand-alone and complementary treatment for arm volume, symptoms, and quality of life (QOL) in women with breast cancer-related lymphedema.
  
  
  METHODS
  A three-group, pilot, randomized clinical trial.
  
  
  METHODS
  A private rehabilitation practice in the southeastern United States.
  
  
  METHODS
  46 breast cancer survivors with treatment-related lymphedema.
  
  
  METHODS
  Patients were screened for eligibility and then randomized to either manual lymphatic drainage (MLD) for 40 minutes, LLLT for 20 minutes, or 20 minutes of MLD followed by 20 minutes of LLLT. Compression bandaging was applied after each treatment. Data were collected pretreatment, daily, weekly, and at the end of treatment.
  
  
  METHODS
  Independent variables consisted of three types of APN-administered lymphedema treatment. Outcome variables included limb volume, extracellular fluid, psychological and physical symptoms, and QOL.
  
  
  RESULTS
  No statistically significant between-group differences were found in volume reduction; however, all groups had clinically and statistically significant reduction in volume. No group differences were noted in psychological and physical symptoms or QOL; however, treatment-related improvements were noted in symptom burden within all groups. Skin improvement was noted in each group that received LLLT.
  
  
  CONCLUSIONS
  LLLT with bandaging may offer a time-saving therapeutic option to conventional MLD. Alternatively, compression bandaging alone could account for the demonstrated volume reduction.
  
  
  CONCLUSIONS
  APNs can effectively treat lymphedema. APNs in private healthcare practices can serve as valuable research collaborators.
  
  
  CONCLUSIONS
  Lasers may provide effective, less burdensome treatment for lymphedema. APNs with lymphedema certification can effectively treat this patient population with the use of LLLT. In addition, bioelectrical impedance and tape measurements can be used to assess lymphedema.
authors.affiliation: School of Nursing, Vanderbilt University, Nashville, TN, USA. sheila.ridner@vanderbilt.edu
authors.forename: Sheila H
authors.initials: SH
authors.lastname: Ridner
authors.forename: Ellen
authors.initials: E
authors.lastname: Poage-Hooper
authors.forename: Collin
authors.initials: C
authors.lastname: Kanar
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Doersam
authors.forename: Stewart M
authors.initials: SM
authors.lastname: Bond
authors.forename: Mary S
authors.initials: MS
authors.lastname: Dietrich
mesh_terms: D000368:Aged; D001458:Bandages; D001943:Breast Neoplasms / Q000150:complications* / Q000451:nursing / Q000523:psychology; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D028022:Low-Level Light Therapy / Q000379:methods*; D008209:Lymphedema / Q000209:etiology / Q000451:nursing / Q000628:therapy*; D008875:Middle Aged; D026201:Musculoskeletal Manipulations; D009859:Oncology Nursing / Q000379:methods*; D010865:Pilot Projects; D011581:Psychological Tests; D011788:Quality of Life; D016896:Treatment Outcome